Provider First Line Business Practice Location Address:
4060 FAIRMOUNT AVE
Provider Second Line Business Practice Location Address:
CHIROPRACTIC DEPARTMENT
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-798-3947
Provider Business Practice Location Address Fax Number:
619-269-1302
Provider Enumeration Date:
03/28/2007